Breast Augmentation: A RealSelf Glossary

Don't know the difference between a BL and a TUBA? Think "drop and fluff" describes driving to the dog groomer? And isn't "bottoming out" a term reserved for the real estate market?

It's OK if you're confused—we're here to help. Here's a quick vocabulary lesson so you can navigate your breast augmentation with educated ease.


Most women's breasts aren’t perfectly symmetrical. Asymmetries should be evaluated by your surgeon, and a surgical plan should be formulated that gives you the best chance of breast symmetry after surgery.


Breast augmentation. Simply put, it's a surgery intended to enlarge the breast either by saline or silicone breast implants (also called augmentation mammoplasty), or through the transfer of body fat into the breast.


Breast lift. Gravity gets to everything eventually—including your breasts. And, if you throw in a few breastfed babies or significant weight loss, you created the perfect storm for breast sagging. A BL (also known as mastopexy) aims to tighten loose skin and restore your breasts to a perky place. There are four primary incision styles available for saying goodbye to sag: crescent, donut, lollipop, and anchor.

Boob greed

A post-op worry that you haven't gone big enough.

Boobie blues

A period of low mood or sadness following BA surgery. Surgery can be physically and emotionally taxing, and adding pain meds and lack of sleep to the mix may cause mild depression.

Keep in mind that as your body heals, your mood will likely elevate—but be sure to report the "blues" to your doctor, particularly if your symptoms are severe.

Bottoming out

Bottoming out can describe two different situations, but both require surgical revision:

  1. When the implants work their way below the crease under your breast, appearing as if they're sliding down the chest.

  2. When the weight of the implants stretches out the skin and soft tissues of the bottom of the breasts. The fold underneath the breasts are intact, but the implants drag the bottom of the breasts far below the IMFs. This type of bottoming out can happen with any size implant but is more common with large implants.

Bottoming Out


Breast width diameter or breast base diameter. The BWD is a pre-procedure measurement your surgeon uses to select the right size implant. To determine your BWD, the breast is measured from the cleavage to it's outer edge. Women's breasts usually range from 11-14 centimeters, and it's best to opt for an implant slightly narrower or the same size as your BWD.


Capsular contracture describes breasts that feel and may even look rock hard. The implants themselves don't harden after surgery, but there is some risk that the tissue that surrounds them can. Dr. Steven H. Williams, a San Francisco plastic surgeon, says there are four grades of capsular contracture, ranging from a Grade I, where the breast is soft and looks natural, to a Grade IV, where the breast is firm, painful, and abnormal-looking. The correction for severe capsular contracture usually includes the replacement of your implants.

Capsular Contracture

Cubic centimeter

30 cc = one ounce, so a 360 cc implant has approximately the same volume as a 12-ounce glass of water. A cc is a measurement that determines the size (or volume) of your breast implant. Sizes range from 120 cc to 800 cc, although small to mid-range 250 cc to 350 cc implants are the most popular. The more moderate implants are associated with a lower rate of short and long-term postoperative complications than large volume implants (500 cc and up).

If your breasts are asymmetrical pre-op, your plastic surgeon may use two different sizes to create a more balanced look. However, breasts with implants of significantly different size tend to age very differently. Many surgeons prefer to alter the breasts so that they have about the same volume of natural tissue, which allows the surgeon to place implants of equal volumes, ensuring the best chance of long-term symmetry as the breasts age.

D & F

Drop & fluff. When implants are first placed, swelling and stretching of the muscle may push the implants upward, creating an unnatural look. Eventually, as the body heals, the implants should "drop" into place and the tissues will soften and "fluff." This process can take several weeks.

D & F is seen primarily in two situations: Young patients with very small/very perky breasts and/or very tight breast skin, and in most patients in which large implants are placed. When smaller, more natural-appearing implant volumes are used the augmented breasts tend to have a natural appearance immediately after surgery.

Double bubble

This problem most commonly occurs on the bottom of the breasts when you can feel or see the breast implant below the “previous” breast fold area. One “bubble” is caused by the breast implant and the other by the breast tissue, creating the double bubble.

Dual plane 

A common surgical technique where the top part of the implant is placed under the muscle and the bottom half is covered by your breast tissue. Dr. Brooke R. Seckel, a Boston plastic surgeon, said the technique "Allow[s] an upward rotation or lift of the breast, which is very helpful in breasts that have a little sag."

Fat transfer (to the breast)

A "natural" option for breast augmentation. This "scarless" BA method involves liposuctioning fat from the abdomen and thighs and injecting it into the breasts.

Frankenboob/Spongebob square boob

The high "rectangular" or "square" appearance of breasts immediately after surgery. But, like morning boob, frankenboob doesn't stick around for good. As the post-op swelling resolves, it's likely that the breasts will drop, soften, and look less boxy.


Gummy bear

A highly cohesive silicone gel breast implant. The gel in these implants is in a solid state and has a firmer feel. But don’t worry, they’re not actually as firm as real gummy bears!

Silicone implants have been around since the '60s; originally the gel was in a liquid state. Since 2006, the silicone gel implants available in the U.S. have been filled with cohesive rather than liquid gel.

Gummy bear implant benefits include a potentially greater ability to retain their shape over time and potentially less risk for rippling. The primary downside is they feel noticeably firmer than cohesive gel implants.

Implant distortion

Also known as "animation" deformity or "muscle flex" deformity. When implants are placed under the muscle, ideally there is little to no visible change in breast appearance when the pec muscles are actively contracted. However, in some patients there can be some degree of breast animation or distortion when the chest muscles are used. Changing the implant position from subpectoral to submammary can eliminate animation deformities, but may not be an option in patients with limited natural breast tissue.

*Treatment results may vary

Dr. Larry Schlesinger, a Honolulu plastic surgeon, explains why a breast implant moves when the pectoralis muscle is flexed.

(Breast) implant revision

Even if your breast implants were placed properly the first time, changes to the breasts and implants can still happen over time. Revision is typically performed on those who have experienced implant rupture, implant rippling, capsular contracture, asymmetrical results, or sagging due to aging, pregnancy, or weight fluctuations. It’s also commonly performed on women who are dissatisfied with the look and feel of their current implants and wish to replace them with a different size or style.

Morning boob

Implants that temporarily harden upon awakening. The condition will not last forever and will dissipate once your muscles adjust.

Pre-op & post-op

Pre-operative and post-operative.

Profile: UHP/HP/MHP

Ultra high profile, high profile, moderate profile. Profile is how far your implants project (or stick out) from your chest. “It is important for patients to understand that these terminologies vary between companies,” says Dr. Michael Law, a Raleigh-Durham, N.C., plastic surgeon. “What one implant company calls ‘moderate plus’ may equate at another company to ‘moderate’. So the actual physical dimensions of projection and base diameter measured in centimeters, is much more important than the ‘profile name’ of the implant.”



Plastic surgeon.


An implant with a symmetrical shape. Implant shapes come in two variations, round or shaped (also known as "anatomical," "teardrop," or "contoured"). Round implants are equally full at the top and bottom when sitting flat on a countertop, but when held upright (as when a patient is sitting or standing upright) they are fuller at the bottom than they are at the top. Below is an example of a smooth, round saline implant.

Saline Round


What the outer shell of your implant may feel like. Implant shells comes in two varieties, smooth or textured. Textured implants were initially intended to reduce the risk of capsular contracture and to keep the implant from shifting (or flipping) out of position. Whether they do or do not actually provide those benefits in most patients remains somewhat controversial.


Saline implants have a silicone shell filled with sterile saltwater (a fluid similar to what’s already in your body). So what makes saline different from silicone? Dr. Arthur Cambiero, a Las Vegas plastic surgeon, says, “Silicone feels and looks more natural and [you can see and feel] ripples [or the natural folds of the implant] less. Saline feels and looks a little less natural and ripples more. But the incision is smaller with saline and bigger with silicone.”

A newer option, "structured" saline implants feel more like silicone gel implants and less like conventional, single-chamber saline implants. Structured implants have two separate saline chambers and multiple internal, solid silicone membranes or "baffles" that help to create an implant feel that is closer to cohesive silicone gel.


Silicone implants have a silicone shell filled with a “squishy,” gel-like substance comparable to natural breast tissue. Below is an example of a smooth round silicone implant.

Round Silicone


Surgery. Make sure your surgeon is board certified in plastic surgery.

Tear-drop or shaped implants

An anatomical or contour-shaped implant. The implant shape is pre-formed to resemble the sloping "tear-drop" quality of a natural breast. Shaped implants must maintain their vertical orientation to appear natural; if they rotate then breast appearance may become distinctly unnatural.

*Treatment results may vary

Dr. Luis H. Macias, a Los Angeles facial plastic surgeon, shares who might be a good candidate for a shaped implant.

Transaxillary, periareolar, crease/inframammary, or TUBA

BA incision sites. There's more that one way to get an implant to its final destination. You can insert the implant through an incision in your armpit (transaxillary), near the nipple (periareolar), under your breast (crease/inframammary), or even go for the somewhat controversial TUBA (aka trans-umbilical breast augmentation) via your belly button.

Incisions 1
Incisions 2

Unders & overs

This is where your surgeon decides to place your implants. Implants are inserted under or over the chest muscles. These muscles, called the pectoralis major, rest over the rib cage and underneath part but not quite all of the breasts. If your plastic surgeon placed an implant "under" your pecs, you've got an "under" or subpectoral (aka submuscular), while an "over" or a subglandular (aka submammary) is placed above these muscles. The red arrow in the illustration below points to the pectoralis muscle. Many plastic surgeons prefer unders as they tend to look softer and less "done," and there's decreased risk of rippling and capsular contracture. It's also easier for radiologists to visualize more breast tissue in mammogram images when implants are placed under.

Under and Over


Symmastia or uni-boob happens when "at rest, your implants touch (i.e., the skin over them touches in the [middle])," says Dr. Alan M. Engler, a New York plastic surgeon. Correction of symmastia requires a surgical procedure to restore a soft tissue barrier between the two implant pockets in the cleavage area.

Upper & lower pole

The upper and lower parts of the breast. The upper pole is above the nipple while the lower pole is below the nipple.

Some women prefer upper pole fullness and select implants that result in very full, round, or "high" cleavage. Others may opt for more fullness in the lower pole, which is thought to better imitate the look of a natural breast.


Tingling or burning breast pain following the operation. According to Dr. Lavinia Chong, an Orange County, Calif., plastic surgeon, these "intermittent burning, sharp, episodic sensations starting from the rib cage and radiating towards the nipple" are alarming to the patient but not unusual. In most cases, they will resolve completely within the first six to 12 months after surgery.

Looking for more?

This guide has been reviewed for medical accuracy by Dr. Michael Law, an independent expert and Raleigh-Durham, N.C., plastic surgeon. Dr. Law is certified by the American Board of Plastic Surgery and is a member of the American Society of Plastic Surgeons.

Disclaimer: This content is for educational and informational purposes only. It is not a substitute for medical advice, diagnosis, or treatment provided by a qualified healthcare professional. Your reliance on any information or content provided in the guide is solely at your own risk. You should always seek the advice of your physician or healthcare professional for any questions you have about your own medical condition. RealSelf does not endorse or recommend any specific content, procedure, product, opinion, healthcare professional, or any other material or information in this guide or anywhere on this website.

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